Ketamine: Another Rapid Responding Antidepressant!

More Hope in the Treatment of Depression

Ketamine, a drug used as an anesthesia for children and animals, and known on the streets as Special K, is now being studied for its rapid responding antidepressant effects. (1) As mentioned in a previous hub about the hope Scopolamine offers as a rapid responding antidepressant, typical antidepressants can take several weeks to relieve depression symptoms. Some people require several trials of different antidepressants, and some do not respond at all to antidepressants. Some have severe, adverse reactions to antidepressants. For these, antidepressant medication is not a viable option at all. Antidepressants fail to help 40% of depressed patients. 70% of these treatment resistant patients with major depression and bipolar depression improve dramatically within a day of taking one dose of ketamine. (1)

For a person who is hopeless and suicidal, waiting several weeks or more for a therapeutic response is risky. Hospitalization for several weeks is costly and may not be fully covered by insurance. Suicide is gaining recognition as a public health crisis that claimed 34,598 American lives in 2007, the most recent year statistics are available. (2) Reducing health care costs is a national priority as well. So, the motivation to find a rapid responding antidepressant is currently very high.

Boost in Neuronal Connectivity Produces Antidepressant Effect

Neuronal spines, budding connections between brain cells, or synapses, sprouted in rats within hours of receiving ketamine (arrows). By contrast, fewer spines developed on neurons of control rats that didn't receive the drug. The boost in neuronal co

More About Ketamine

Ketamine Boosts Brain Connections

Ketamine works to relieve depression within hours by stimulating connections between brain cells. It acts on glutamate mechanisms in the executive functioning part of the brain known as the prefrontal cortex, and stimulates responses in existing neurons. This is a more direct effect than traditional antidepressants that target serotonin mechanisms and trigger the birth of new neurons in the brain’s hippocampus.

The fact that ketamine acts on glutamate mechanisms, by blocking the binding of glutamate to receptors, has been known. New research (3) conducted by Dr. Ron Dumann at Yale University followed the path of activity triggered by this blockade, and discovered that ketamine activates an enzyme (mTOR) that makes proteins that form neuronal connections. Conventional antidepressants do not activate the mTOR enzyme, nor does ECT (electroconvulsive therapy or shock therapy) which is often used when antidepressants fail.

Ketamine has the opposite effect of stress and depression, which causes synapses to shrivel. Ketamine was shown to quickly reverse depression-like behaviors in rats exposed to stress. The effects lasted up to a week. This might suggest future uses for preventing mood disorders, or worsening of symptoms related to stress, and perhaps even preventing stress related medical conditions. A related research has identified a brain signal that is detectable using a MEG scanner that predicts whether a patient will likely respond to ketamine treatment. The mTOR enzyme makes proteins in other parts of the body as well, and is associated with some forms of cancer.

Ketamine is also a substance that is readily abused on the streets because of its psychedelic and dissociative effects. While we seem to be getting closer to finding fast acting treatments for depression, there are safety concerns related to the use of ketamine, and more research needs to be done before ketamine will be available to treat depression. The motivation to find and produce a rapid responding antidepressant is very high, and may be helpful in moving the research along so that treatments might soon become available.

Comments

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AUTHOR

Kim Harris

7 years ago

I'MA TELL MUVA!!!

imatellmuva

7 years agofrom Somewhere in Baltimore

I have found your hubs more than helpful! I've read a number of articles on this subject...more than I can remember.

Your hubs have been more helpful to me, than any other article that I've ever read. I don't say this to gas you up. I am one who speaks openly and honestly, and I sincerely mean what I say! Perhaps it was meant for you to find me, so that I could in turn find that YOU write on a subject that I am currently helping someone to manage (and to mention your other work - your pretty darn awesome!)So thanks to you, for being you, and having a style of writing with a content that I can apprecaite AND use!! YOU GO GUUURLLLLL!!!!!

AUTHOR

Kim Harris

7 years ago

I hope you did find these hubs helpful, but Ketamine and Scopalamine are far away from FDA approval. I like sites like health.gov, webMD and nimh.nih.gov..... I just went to health.gov and found this pamplet about finding a provider for your friend/loved one that you mentionned at the other hub. http://www.dbsalliance.org/pdfs/finding.pdf I hope it helps. Thanks so much for reading and commenting imatellmuva:)

imatellmuva

7 years agofrom Somewhere in Baltimore

I'll tell you...the more I read about antidepressant meds, or meds that can be used as an antidepressnt, the more I understand why folks who suffer from depression either refuse treatment or seek alternatives for care. The near immediate relief from depression and depression like symptoms are appealing, but the side-effects are as, or nearly as scary as the depression itself.

Nevertheless, this article and the one on scopolamine are helpful to me. I am trying desperately to educate myself more about depression. Thanks Kimh039!

AUTHOR

Kim Harris

7 years ago

like standing watch in the middle of the night in the jungle with banana trees? Yep some antidepressants help with anxiety as well, and aren't as addictive as xanax, valium, klonopin and the like. Good to see you Micky Dee.....without your banana tree.

Micky Dee

7 years ago

I've had to take them a couple times but weaned myself off when I could. Some traumatic events cause for them. God bless you Kim!

AUTHOR

Kim Harris

7 years ago

Don't know vern. here's a cut and paste from www.lexapro.com about how it acts to increase serotonin, but not the specifics of where and how.....another hub i guess!

How Lexapro works

Lexapro is believed to work by increasing serotonin, a substance in the brain believed to influence mood.

How SSRIs work

Although the brain chemistry involved in depression or anxiety is not fully understood, it is widely recognized that chemical messengers facilitate communication between nerve cells in the brain and are involved in regulating many aspects of behavior and mood. These chemicals are called neurotransmitters and it is believed that neurotransmitter imbalances play an important role in the development of depression and anxiety. Serotonin is a neurotransmitter that has been clearly linked with most, if not all, forms of depression. SSRIs are believed to work by blocking the reabsorption (reuptake) of serotonin in the brain, thus increasing available serotonin.

Vernon Bradley

7 years agofrom Yucaipa, California

I try to find as much as I can about the antidepressant effects on brain, and it is interesting that you mention the hippocampus. Lexipro enhances a specific feedback loop between hippocampus and prefrontal lobe. Do you know if all antidepressants do that or are supposed to do that?

Vern

AUTHOR

Kim Harris

7 years ago

Undesireable maybe, possibly even beneficial, but not terrible, Vern! Long live Albert Ellis.

Re placebos: Whether it's a widely prescribed medication or a placebo, a successful treatment for depression must trigger a common pattern of brain activity changes, suggests a team of researchers funded by the National Institute of Mental Health………….. "Our findings do not support the notion that antidepressants work merely via a placebo effect," cautioned Mayberg, who has since moved to the Rotman Research Institute at the University of Toronto. "Patients on active medication who failed to improve did not sustain the brainstem, striatal, and hippocampus changes unique to antidepressant responders."……………. "Treatment with placebo is not absence of treatment, just absence of active medication," note the researchers, citing possible therapeutic benefits of a change in environment and the supportive, therapeutic milieu of an inpatient psychiatric ward. (*)

You know I HAD TO look! Thanks for the read, the comment and the challenge Vern. Love your comments.

Vernon Bradley

7 years agofrom Yucaipa, California

Thank you for updating all of us on this important, unfortunately important topic. Many of my clients are almost constantly asking questions about antidepressants, because they go through several over the course of several years and are always looking for THE ONE. I don't know how much study is going on with placebos, but that is a great effect which I try to use all the time for both myself and make suggestions to others how they can use it in their lives. Pill bottle full of almonds, for example, as long as you are not allergic to nuts!! Thank God, I'm not. My whole family, including myself, we are all one big nut!! So it would terrible to be allergic!!

Thanks again, Kim. You're an excellent researcher.

Vern

AUTHOR

Kim Harris

7 years ago

Thanks for the extra info, vrajavala. I wanted to be sure when I published it that I wasn't coming across as promoting illegal ketamine use in any way, so thanks for the extra emphasis. It is definitely not ready to be used safely as an antidepressant. There are also psychological side effects to the street use of ketamine and other physical dangers.....another hub perhaps. Thanks so much for reading and commenting vrajavala.

vrajavala

7 years agofrom Port St. Lucie

the side effects: "The results of a study, published in the Hong Kong Medical Journal, following a small group of users who had been involved with the drug over a four-year period concluded that K was responsible for causing bladder and kidney damage. Users complain of K-pains when coming down from a trip and may turn to opioids to deal with their discomfort. Urinary tract infections are very common among Vitamin K users, and drinking cranberry juice may help to prevent this side effect."

interesting hub. I think a lot more research has to be done to counteract the "high" and tripping effects of ketamine.

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